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Meta-Analysis
. 2019 Apr;15(1):121-129.
doi: 10.5152/iao.2019.5937.

The Clinical Benefit of Device Therapy for Meniere's Disease in Adults: Systematic Review and Meta-Analysis

Shu Jia Wang  1 , Hong Yang  2 , Yang-Yang Yao  3 , Hui-Yun Gu  3 , Lu-Lu Lin  1 , Chao Zhang  1 , Jie Luo  2
Affiliations
Meta-Analysis

The Clinical Benefit of Device Therapy for Meniere's Disease in Adults: Systematic Review and Meta-Analysis

Shu Jia Wang et al. J Int Adv Otol. 2019 Apr.

Abstract

Objectives: This study aimed to assess the clinical benefit of device therapy on controlling the symptoms of Meniere's disease (MD).

Materials and methods: We searched PubMed, Embase, the Cochrane Library, China National Knowledge Internet, and Wanfang Data before January 13, 2018. We selected randomized controlled clinical trials, case-controlled studies, and cohort studies that dealt with outcomes of device therapy for the treatment of MD.

Results: Sixteen trials met our inclusion criteria. The use of device therapy resulted in improved vertigo control, which was described as a reduction in the number of vertigo days by month (weighted mean difference [WMD]: 3.15, 95% confidence interval [CI]: 2.00-4.31), in the number of vertigo episodes by month (WMD: 7.37, 95% CI: 2.40-12.35), and in the vertigo visual analog score (WMD: 41.51, 95% CI: 34.68-48.34). In addition, the overall complete vertigo control (class A) rate was 50% (95% CI: 37%-64%). The device therapy also reduced the number of sick days by month (WMD: 4.56, 95% CI: 2.15-6.97), and the functional level improved (WMD: 2.66, 95% CI: 2.15-3.17). The electrocochleographic parameters decreased. The device therapy proved beneficial for hearing changes (WMD: 3.19, 95% CI: 0.66-5.71). No publication bias was found in the funnel plot and the results of Egger's test.

Conclusion: This study showed that the device therapy might reduce vertigo attacks and sick days in patients with MD. Additionally, the function level and hearing level may improve after the device therapy. In addition, the decrease in electrocochleographic parameters showed that inner ear electrophysiology improved after device therapy.

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Conflict of interest statement

Conflict of Interest: The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Summary of trial identification and selection.
Figure 2
Figure 2
Forest plot of the number of vertigo days by month.
Figure 3
Figure 3
Forest plot of the number of vertigo episodes by month.
Figure 4
Figure 4
Forest plot of the visual analog score of vertigo.
Figure 5
Figure 5
Forest plot of overall complete vertigo control (class A) rate.
Figure 6
Figure 6
Forest plot of hearing change.
Figure 7
Figure 7
Forest plot of the sick days by month.
Figure 8
Figure 8
Forest plot of electrocochleograph parameters recording.
Figure 9
Figure 9
Forest plot of functional level.
See this image and copyright information in PMC

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